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Critical role of nutrition in improving quality of care: an interdisciplinary call to action to address adult hospital malnutrition.

Authors
  • Tappenden, Kelly A
  • Quatrara, Beth
  • Parkhurst, Melissa L
  • Malone, Ainsley M
  • Fanjiang, Gary
  • Ziegler, Thomas R
Type
Published Article
Journal
JPEN. Journal of parenteral and enteral nutrition
Publication Date
Jul 01, 2013
Volume
37
Issue
4
Pages
482–497
Identifiers
DOI: 10.1177/0148607113484066
PMID: 23736864
Source
Medline
Keywords
License
Unknown

Abstract

The current era of healthcare delivery, with its focus on providing high-quality, affordable care, presents many challenges to hospital-based health professionals. The prevention and treatment of hospital malnutrition offer a tremendous opportunity to optimize the overall quality of patient care, improve clinical outcomes, and reduce costs. Unfortunately, malnutrition continues to go unrecognized and untreated in many hospitalized patients. This article represents a call to action from the interdisciplinary Alliance to Advance Patient Nutrition to highlight the critical role of nutrition intervention in clinical care and to suggest practical ways to promptly diagnose and treat malnourished patients and those at risk for malnutrition. We underscore the importance of an interdisciplinary approach to addressing malnutrition both in the hospital and in the acute posthospital phase. It is well recognized that malnutrition is associated with adverse clinical outcomes. Although data vary across studies, available evidence shows that early nutrition intervention can reduce complication rates, length of hospital stay, readmission rates, mortality, and cost of care. The key is to systematically identify patients who are malnourished or at risk and to promptly intervene. We present a novel care model to drive improvement, emphasizing the following 6 principles: (1) create an institutional culture where all stakeholders value nutrition, (2) redefine clinicians' roles to include nutrition care, (3) recognize and diagnose all malnourished patients and those at risk, (4) rapidly implement comprehensive nutrition interventions and continued monitoring, (5) communicate nutrition care plans, and (6) develop a comprehensive discharge nutrition care and education plan.

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